Abstract：
BACKGROUND: Maternal folate may not reach an optimal level to prevent neural tube defects if supplementation commenced post-conception or took place pre-conception only. Our study aimed to investigate the continuation of folic acid (FA) supplementation from pre-conception to post-conception during peri-conceptional period and to examine its differences in FA supplementation between the subgroups taking the initiation timing into consideration.
METHODS: This study was conducted in two community health service centers in Jing-an District of Shanghai. Women accompanying their children to pediatric health clinics of the centers were recruited and asked to recall information concerning their socioeconomic and previous obstetric characteristics, utilization of healthcare and FA supplementation before and/or during pregnancy. The continuation of FA supplementation during peri-conceptional period were categorized into three subgroups: Supplementing with FA pre- and post-conception; supplementing with FA preconception only or post-conception only; no FA supplements pre-conception and post-conception. The relationship between FA continuation and couples\' characteristics were examined as setting the first subgroup as the base reference.
RESULTS: Three hundred and ninety-six women were recruited. Over 40% of the women started FA supplementation after conception and 30.3% of them supplemented with FA from pre-conception to the first trimester of their pregnancy. Compared to this one-third of participants, women who didn\'t supplemented with any FA during peri-conceptional period were more likely to have no utilization of pre-conception healthcare ([Formula: see text]= 2.47, 95% [Formula: see text]: 1.33-4.61) or antenatal care ([Formula: see text]= 4.05, 95% [Formula: see text]: 1.76-9.34), or who had a lower family socioeconomic status ([Formula: see text]= 4.36, 95% [Formula: see text]: 1.79-10.64). Women who supplemented with FA pre-conception only or post-conception only were more likely to have no utilization of pre-conception healthcare ([Formula: see text]= 2.94, 95% [Formula: see text]: 1.79-4.82), or to have no previous pregnancy complication ([Formula: see text]=1.80, 95% [Formula: see text]: 0.99-3.28).
CONCLUSIONS: Over two-fifth of the women started FA supplementation and only one-third of them had an optimal supplementation from pre-conception to the first trimester. Maternal utilization of healthcare before or during pregnancy together with maternal and paternal socioeconomic status may play a role in the continuation to FA supplementation pre- and post-conception.
METHODS: This study was conducted in two community health service centers in Jing-an District of Shanghai. Women accompanying their children to pediatric health clinics of the centers were recruited and asked to recall information concerning their socioeconomic and previous obstetric characteristics, utilization of healthcare and FA supplementation before and/or during pregnancy. The continuation of FA supplementation during peri-conceptional period were categorized into three subgroups: Supplementing with FA pre- and post-conception; supplementing with FA preconception only or post-conception only; no FA supplements pre-conception and post-conception. The relationship between FA continuation and couples\' characteristics were examined as setting the first subgroup as the base reference.
RESULTS: Three hundred and ninety-six women were recruited. Over 40% of the women started FA supplementation after conception and 30.3% of them supplemented with FA from pre-conception to the first trimester of their pregnancy. Compared to this one-third of participants, women who didn\'t supplemented with any FA during peri-conceptional period were more likely to have no utilization of pre-conception healthcare ([Formula: see text]= 2.47, 95% [Formula: see text]: 1.33-4.61) or antenatal care ([Formula: see text]= 4.05, 95% [Formula: see text]: 1.76-9.34), or who had a lower family socioeconomic status ([Formula: see text]= 4.36, 95% [Formula: see text]: 1.79-10.64). Women who supplemented with FA pre-conception only or post-conception only were more likely to have no utilization of pre-conception healthcare ([Formula: see text]= 2.94, 95% [Formula: see text]: 1.79-4.82), or to have no previous pregnancy complication ([Formula: see text]=1.80, 95% [Formula: see text]: 0.99-3.28).
CONCLUSIONS: Over two-fifth of the women started FA supplementation and only one-third of them had an optimal supplementation from pre-conception to the first trimester. Maternal utilization of healthcare before or during pregnancy together with maternal and paternal socioeconomic status may play a role in the continuation to FA supplementation pre- and post-conception.
摘要：
背景：如果在受孕后开始补充或仅在受孕前进行补充，母体叶酸可能无法达到最佳水平以预防神经管缺陷。我们的研究旨在调查在孕周期间从孕前到孕后补充叶酸（FA）的持续情况，并考虑到开始时间，研究亚组之间在补充FA方面的差异。
方法：本研究在上海市静安区的两个社区卫生服务中心进行。招募了陪伴孩子到中心儿科诊所的妇女，并要求其回忆有关其社会经济和先前产科特征的信息。怀孕前和/或怀孕期间医疗保健和FA补充的利用。在孕周期间继续补充FA分为三个亚组：孕前和孕后补充FA；仅在孕前或孕后补充FA；没有FA补充孕前和孕后。将第一亚组作为基础参考，检查了FA延续与夫妻特征之间的关系。
结果：招募了三百九十六名妇女。超过40％的妇女在受孕后开始补充FA，其中30.3％的妇女从受孕前到怀孕的头三个月补充FA。与这三分之一的参与者相比，在受孕期间未补充任何FA的妇女更有可能没有使用孕前保健（[公式：见文本]=2.47，95％[公式：见文本]：1.33-4.61）或产前保健（[公式：见文本]=4.05，95％[公式：见文本]：1.76-9.34），或家庭社会经济地位较低的人（[公式：见正文]=4.36，95%[公式：见正文]：1.79-10.64）。仅在受孕前补充FA或仅在受孕后补充FA的妇女更有可能没有使用受孕前医疗保健（[公式：见文本]=2.94，95％[公式：见文本]：1.79-4.82），或没有先前的妊娠并发症（[公式：见文本]=1.80，95％[公式：见文本]：0.99-3.28）。
结论：超过2/5的妇女开始补充FA，只有1/3的妇女从孕前到孕早期有最佳补充。母亲在怀孕前或怀孕期间利用医疗保健以及母亲和父亲的社会经济地位可能在怀孕前后继续补充FA中起作用。
方法：本研究在上海市静安区的两个社区卫生服务中心进行。
结果：招募了三百九十六名妇女。
结论：超过2/5的妇女开始补充FA，只有1/3的妇女从孕前到孕早期有最佳补充。
